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Thanksgiving at the E.R.: When a turkey feast proves too much of a good thing

November 24, 2009 | 12:25
pm

Take this as a cautionary tale.

The man was covered in sweat, clutching his chest, when he entered an emergency room on Thanksgiving some years back. His next words are fixed in the memory of Dr. Mark Morocco, associate residency director of emergency medicine at UCLA.

“I just ate a lot of meatballs. ... Oh, my God, here it comes!” -- and then his mother's meatballs, more than a dozen, made their reappearance in triage.

Yes, on this Thanksgiving, you can eat too much too quickly, to the point where you might just feel sick enough to go to the emergency room.

"We see, routinely, people who come in who think they are dying," Morocco said, "and really what they have done is overeaten, and they just feel bad.”

In the early hours of Thanksgiving, while footballs are tossed or watched and turkeys roast, emergency rooms are typically virtually empty.

It’s after the eating begins in the afternoon that people begin to arrive.
“It never fails, every year,” said Dr. Nagi Sous, who heads the emergency room at Kaiser Permanente Los Angeles Medical Center.

There are the times when whole families turn up.
“One badly cooked turkey can easily strike a blow at a dozen people at Grandma’s house on Thanksgiving,” Morocco said.

“If you thaw a turkey wrong or cook a turkey wrong ... it’s an opportunity for turkeys to get even with the human population.”

The problem often begins when the cook thaws the turkey for 12 hours on a counter top -- or leaves the roasted bird out for two or three hours before serving it.

During that time, a virus or bacterium can land on the food and start growing, Sous said.

A virus can cause gastroenteritis, sometimes referred to the stomach flu. Simply reheating the meat may not fix the situation. Although heat will kill bacteria, toxins made by the bacteria that cause illness can survive even in a hot oven.

Morocco cited a case reported in 1986 by the U.S. Centers for Disease Control and Prevention, in which a buffet served to 855 people at a New Mexico country club sickened at least 67 of them.

Twenty-four needed emergency treatment or hospitalization.
Scientists later determined that the turkey had Staphylococcus aureus bacteria, which also were found in two food handlers’ noses.

“The turkey had cooled for three hours at room temperature after cooking," officials concluded, "a time and temperature sufficient for bacterial proliferation and toxin production.”

Sous said those experiencing an upset stomach should drink only clear liquids; continuing to eat or taking aspirin or Alka Seltzer or some other remedy might only trigger more suffering.

Sometimes, trips to the hospital are the result of a fish bone stuck in the esophagus, the tube connecting the stomach to the mouth. Other times, it’s a chicken bone. Or a large piece of pork. Or a chunk of steak. The sufferer may be able to breathe but might not be able to eat or even to swallow saliva.
When that happens, doctors sometimes use a long tweezer to take out the offending item or insert a long tube, with a tiny camera attached, to nudge the lodged piece of food on to the stomach, said Dr. Gail Carruthers, director of the pediatrics emergency department at Long Beach Memorial Medical Center and Miller Children’s Hospital.

She exhorted people to follow two rules of thumb: “Don’t overeat. Chew your food.”